Individual provider Active NPI

Gabriel Mannarino, DDS

  • General Practice Dentistry
  • Burlington, VT
National Provider Identifier
1730396060
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
018656 Issued in MI
Practice address
27 N Willard St
Burlington, VT 05401-3312
Phone
(802) 862-8625
NPI assigned
May 17, 2007
Last updated
May 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 018656 MI Primary

Addresses

Primary practice location

27 N Willard St
Burlington, VT 05401-3312

Mailing address

467 Westview Cir
Williston, VT 05495-7352
Phone (313) 300-8995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
018656MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Willard Street Family Dental Past Accepting new patients
Barclay & Fersing Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1730396060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 WESTVIEW CIR",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957352",
            "telephone_number": "313-300-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 N WILLARD ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013312",
            "telephone_number": "802-862-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNARINO",
        "first_name": "GABRIEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "018656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.